The West Virginia State Bar
2006 Kanawha Boulevard, East - Charleston, WV 25311-2204 Phone-(304)558-2456/Fax-(304 )558-2467/WV Toll Free Phone-(866)989-8227
 
Application

THE WEST VIRGINIA STATE BAR

LAWYER REFERRAL SERVICE

The referral service offers clients an opportunity to find a lawyer, and lawyers an opportunity to find clients. There is an annual fee of $25 for the participating lawyer, and you must agree to see clients for an initial ½ hour consultation for a fee of no more than $10.

Please join this professional and public service program. Please fill out the registration form below and return it to the State Bar office. If you have any questions, please contact our Lawyer Referral Service Coordinator, Connie M. Blessing at 304/558-7994.

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Name ____________________________ Office Phone # ___________________

Address _________________________ County ___________________________

City ____________________________ Zip ______________________________

1. I (We) will accept referrals in the following counties:

______________________________________________________________

2. I (We) will accept referrals relating to the following matters:

____ administrative ____ DUI ____ labor law

____ admiralty ____ corporate ____ patents

____ banking ____ criminal ____ real estate

____ bankruptcy ____ domestic ____ tax

____ black lung ____ civil ____ coal, oil & gas

____ estate planning ____ insurance ____ ADA

____ immigration ____ personal injury ____ collections

____ legal malpractice ____ medical ____ social security/

malpractice workers comp.

____ landlord/tenant ____ contracts ____ lemon law

____ other _________________________________

Please complete other side and return to the State Bar office.

3. I (We) are covered by an attorney professional liability insurance policy in the amount of $100,000 or more.

a) My insurance carrier is __________________________________

b) My policy number is ______________________________________

c) My policy expires ________________________________________

4. I (We) will abide by the rules and regulations of The West Virginia Lawyer Referral Services.

_________________________________
Signature

Please return $25 payment & form to:    Connie M. Blessing, LRS Coordinator
                                                        The West Virginia State Bar
                                                        2006 Kanawha Boulevard, E
                                                        Charleston, WV 25311-2204

Send Comments to: blessingc@wvbar.org

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